HRT overestimated optic disc area as compared to SD-OCT. A portion of the difference in HRT and SD-OCT disc measurements is due to HRT's magnification correction algorithm. Rim area measurements from HRT were larger than from SD-OCT, likely a result of different definitions for the reference plane and differences in disc area measurements. Disc parameters from the two devices are not interchangeable.
The management of the glaucoma patient who has visually significant cataracts is a practical but complex topic. As glaucoma is a chronic, potentially progressive disease that can lead to irreversible blindness, ophthalmologists should develop a treatment approach with emphasis based on the severity of glaucoma rather than on cataract alone. Trabeculectomy remains an effective surgical choice, especially in glaucoma patients with advanced disease who require a low and steady IOP. In planning for cataract surgery, surgeons should be mindful of the alterations of astigmatism in terms of power and axis, axial length fluctuation as a result of trabeculectomy, and the relative position of the IOL after surgery. As glaucoma is a potentially progressive disease, surgeons who treat patients with coexistent glaucoma and cataracts must consider that future glaucoma surgery may be necessary when planning for the cataract surgery. A complete discussion of alternatives would go beyond the limited scope of this study. Regardless of the procedures used, the surgeon should consider the secondary effects of both glaucoma surgery and cataract surgery and their impact on each other when developing an individualized treatment plan.
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